Science Diction: The Origin Of 'Tuberculosis'

UNIDENTIFIED MAN: The alphabet has only 26 letters. With these 26 magic symbols, however, millions of words are written every day.

IRA FLATOW, HOST:

And that music means it's time for Science Diction, where we talk about the origins of science words with my guest, Howard Markel, professor of the history of medicine at the University of Michigan at Ann Arbor, also director of the Center for the History of Medicine there. Welcome back to SCIENCE FRIDAY, Howard.

DR. HOWARD MARKEL: Hi, Ira, how are you?

FLATOW: How are you?

MARKEL: I'm good.

FLATOW: That's good. You've got an interesting word for us today is?

MARKEL: Yes, it's tuberculosis.

FLATOW: Ooh.

MARKEL: Something you don't want.

(SOUNDBITE OF LAUGHTER)

FLATOW: No.

MARKEL: Used to be a rather romantic disease - so many famous people got it, but it's nothing romantic about that disease.

FLATOW: Speaking of how many people, how far back can you trace tuberculosis?

MARKEL: Oh, you can find ancient mummies with it. The Greeks talked about it. Hippocrates thought it was the most common cause of death in his era. And the word, you know, tuberculosis is really a wasting disease as the microbe takes hold and destroys your lungs and other organs, and you literally whither away and die if it's not treated. So the Greeks used to call it phthisis, which really describe a living body that shrivels on a flame. And the Italians - the Romans called it, consumare, because the disease consumes you. And, in fact, for well into the 20th century, people called tuberculosis consumption.

FLATOW: Yeah, because it looks like it really is consuming you.

MARKEL: Yeah.

FLATOW: And you are a physician, and you have actually, I know, studied tuberculosis as a doctor and had actually contact with it.

MARKEL: Yes, I've treated many patients with tuberculosis. One of the great cases of my internship, we had a young boy, a 3-year old, who had a fever of unknown origin and we could not figure what it was. And being a historian even back then, I said, let's look for tuberculosis. And lo and behold, we found it.

FLATOW: Wow. And how did that modern word come about then, tuberculosis?

MARKEL: Well, of course, it comes from the word tuber, which is a botanical term. It's a - when you have a solid, rounded growth of a stem that bears eyes or buds. And the most familiar example is a potato. But the tubercle, which what the lesion of tuberculosis is called, is really a diminutive of tuber, and it means a small swelling. And that's what you would see if you did an autopsy and you found this lesion in the lungs or the brain or what have you. It's a, it's really the dead tissue that remains after the tuberculosis germ does its evil.

FLATOW: Mm-hmm. So is it the germ then eating you away? Is that why it's called consumption?

MARKEL: Well, in a way, it has this immune response with normal tissue, and the tubercle that remains is the necrotic or dead tissue that remains. It's called caseous necrosis because it reminds you of cheese if you flake it off on autopsy. And I should add that even though it's tubercle, which is the lesion, the -osis part is Greek suffix, which means a disease process, essentially.

FLATOW: So then how does the TB actually kill you?

MARKEL: Well, it takes up - it occupies space in the lungs or other organs and it kills the reaction, that immune reaction between the tuberculosis germ and the normal tissue results in dead tissue. And if it kills enough tissue, well, if it's in the lungs, you have trouble breathing. If it's in the brain, you get TB meningitis, liver, kidneys and so on. But it also tends to erode - this death or dead tissue tends to erode blood vessels. So a lot of people who had pulmonary or lung TB, they would not only have difficulty breathing, but the blood vessels would erode and they would actually bleed to death. They would cough up blood just like at the end of Puccini's "La Boheme," but without the music.

FLATOW: You know, before they had modern antibiotics, they used to have sanitariums, sanitaria...

MARKEL: Yeah.

FLATOW: ...to send people for fresh air. How did that combat tuberculosis?

MARKEL: Well, the fresh air is very interesting. It was particularly cold, fresh air and particularly on high altitudes. And what has since been shown is that the tuberculosis germ loves a lot of oxygen, and that's why it tends to nest itself on the upper, the top part of the lung where the oxygen content is the greatest. If you're high up on a mountaintop, as described in the "Magic Mountain," the oxygen is not nearly as rich, and so they thought that might help kill the tuberculosis germ.

FLATOW: Did it work at all?

MARKEL: A little bit, not much. I'd much rather have antibiotics.

(SOUNDBITE OF LAUGHTER)

FLATOW: So would we all. Howard, thank you very much.

MARKEL: Thank you, Ira.

FLATOW: Thank you for all of these - I know this is the last one out in the series. I want to thank you for all your help in the Science Diction series pieces. Thanks again.

MARKEL: It's in my pleasure. I'll see you in the funny papers, as they say, Ira.

(SOUNDBITE OF LAUGHTER)

FLATOW: Howard Markel is professor of history of medicine at the University of Michigan in Ann Arbor, also director of the Center for the History of Medicine there. Transcript provided by NPR, Copyright NPR.